World AIDS Day

Andrew Gwynne Excerpts

Thursday 1st December 2022 Commons Chamber

[Andrew Gwynne (Denton and Reddish) (Lab)]

I, too, congratulate both my hon. Friend the Member for Brighton, Kemptown (Lloyd Russell-Moyle) on securing this debate, and the Backbench Business Committee on granting it. In thanking my hon. Friend, I want to say that we listened intently to his opening contribution. It was full of wisdom, insight and personal advocacy and showed the commitment that he brings to the issue in this place. The House of Commons is a better place when we speak openly and challenge those in power about the issues that still prevail, not just in this country but across the world when it comes to HIV/AIDS.

On this day, we remember the 40 million people who have lost their lives to the worldwide AIDS pandemic and related illnesses since the disease was first found in the 1980s. In this debate, Members from across the House, in a small, but perfectly formed manner, have raised some important issues. I particularly thank the right hon. Member for Romsey and Southampton North (Caroline Nokes) for the way in which she always challenges inequalities around the world, especially inequalities facing women and girls, and, of course, this is an issue that affects women and girls around the globe. It is an equalities issue, and I thank her for her contribution. I also thank the hon. Members for West Bromwich East (Nicola Richards), for Heywood and Middleton (Chris Clarkson), and for Strangford (Jim Shannon) and even the SNP spokesman, the hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar), for their contributions. The great thing about this issue is that it brings us together in unity on World AIDS Day. This is not a party political issue. As with covid, if we are to defeat the first pandemic, we must work together across party lines, and this has been a good debate because of that.

We all recognise the extraordinary work of those who have fought to eradicate the virus. As has already been said, we have come a long way since the first World AIDS Day in 1988. Here in the UK, we have seen unprecedented scientific advancement. We understand more about HIV, and we have legislated against discrimination to better protect those living with HIV. We have seen some long-overdue justice delivered to victims of the contaminated blood scandal, with interim payments being granted for some—but not all—of those impacted. This victory is a testament to the unstinting work of campaigners and, indeed, colleagues from both sides of the House. However, as has been made clear in the Chamber today, there is still much more work to do with regards to this injustice. I hope that, in his response, the Minister will provide an update to the House on when the Government will respond in full to the 19 recommendations laid out in Sir Robert Francis’s framework for compensation.

This World AIDS Day is not just about recognising and celebrating how far we have come, but about issuing a call to action. There can be no room for complacency in the late stages of this campaign. Today, we stand on the brink of achieving something extraordinary: ending all new HIV transmissions in England by 2030. That goal is ambitious, but achievable, and it is one that Labour is proud to support and to push the Government on to achieving. None the less, too many opportunities are still being missed, and sexual health services are struggling to keep up with demand. A total of 46% of people diagnosed with HIV are still diagnosed too late, and 38% of people attending sexual health services were not offered an HIV test last year. That is not good enough. Some 20% fewer people were tested for HIV in 2021 than in 2019, and research shows that 57% of people have waited more than 12 weeks for PrEP.

Shockingly, in 2021, no local authority in England—not one—reported more than five women accessing PrEP, and there are still stark racial disparities in treatment and in support that must be addressed. I wish to use this debate to press the Minister on what steps the Government are taking to tackle unequal access to sexual health services and, in particular, to PrEP.

In a recent study, 40% of people surveyed reported difficulty in booking a sexual health appointment online; 23% of people were turned away due to a lack of available appointments. With that in mind, what assessment have the Government made of sexual health accessibility levels, and what consideration has the Minister made of making PrEP available beyond sexual health services—for example in GPs, gender clinics, pharmacies and abortion clinics? I assume that that work would be included in the promised PrEP action plan, but that has yet to materialise. Will the Minister commit to an implementation date for this plan today, and if not, why not? Furthermore, what recent assessment has the Minister made of the eligibility criteria for PrEP, and are there any plans to expand it?

PrEP is one side of the coin, but we do not often talk about the other side anymore—partly because of the success of PrEP—and that is access to post-exposure prophylaxis. The publicity has fallen for that, but it is still an important tool in the box for people who are fearing that they may have been inadvertently exposed to the HIV virus. There is a small window for those people who fear that they may have been exposed, or who have been exposed to HIV, to get access to PrEP for it to be successful. What are the Government doing to ensure that there is adequate advice and information on the availability of post-exposure prophylaxis?

Sexual health services are under unprecedented pressure due to mpox. Service displacement means that appointments for PrEP, STI testing and long-active, reversible contraceptives have been cut. That has also led to reported hesitancy by clinics to deliver mpox vaccines. What action will the Minister take to ensure that all those who need the mpox vaccine can access one, and not to the detriment of other vital sexual health services?

Moving to testing, the Minister will no doubt be aware that yesterday, NHS England released its report on HIV and hepatitis opt-out testing in areas of very high prevalence. Labour has been proud to support that for several years. The report shows that because of the tests, more than 800 people living with undiagnosed HIV and hepatitis have been identified in these areas. We have saved an estimated £6 million to £8 million on treatment costs. Put simply, opt-out testing has been a huge success. With that in mind, can the Minister set out whether there are any plans to change the current scope of HIV opt-out testing to include all areas of high prevalence?

Finally, I want to touch on stigma. A study recently published by the Terrence Higgins Trust found that just 38% of people knew that those living with HIV and on effective treatment cannot pass the virus on to partners. Only 30% of people said that they would be comfortable dating somebody with HIV. The HIV epidemic is exacerbated by stigma, ignorance and misinformation. If we want equitable access to HIV treatment, we must proactively tackle the myths and bigotry that still permeate discussions around HIV. I am sure that the Minister will agree wholeheartedly with me about that.

I would be interested to hear the Minister’s assessment of current legislative barriers affecting those living with HIV. A clear example is the fact that LGBT+ people with HIV are still not allowed to access fertility treatment, despite the fact that heterosexual people with HIV are able to do so. That is an out-of-date barrier and it needs scrapping. I am proud that the next Labour Government will equalise access to fertility treatment for LGBT+ people living with HIV. Will the Minister join us in committing to that, and pledge to introduce legislation now—before the general election—to end the restrictions that prevent people with HIV from starting a family?

Labour is committed to the HIV 2030 pledge. It is more than prepared to work on a cross-party basis to make this ambition a reality. But we must address some incredibly concerning trends in HIV treatment and access, and not become complacent because of the progress that has come before us. No new transmissions of HIV by 2030 is still possible. We want to succeed, but there is no time to waste. As my hon. Friend the Member for Brighton, Kemptown said, let us all, together, sprint to that finish line.